Chapter 11

Which of these blood pressure readings is normal for seven year old male?

114/62 mmHg

Which of these blood pressures represents diastolic hypertension in an adult patient?

136/92mmHg

While reviewing a patient care report for a quality assurance process, the EMT should recognize that a blood pressure has been palpated when she sees:

178/P

You are called for a two-year-old female, who is sick. When testing her capillary refill, what would be the greatest cause for concern?

3-second capillary refill time

The EMT recognizes which heart rate would be considered normal for a 24-year-old male patient who is resting comfortably?

62 beat/minute

Which of these patients of the EMT recognizes having a normal skin temperature?

836-year-old male complaining of nausea with warm skin

How should the EMT document a pulse oximetry reading on the prehospital care report?

97% SPO2

Which of these patients should the EMT recognized as tachycardic for his or her age bracket?

A 37-year-old male with a complaint of fatigue and a heart rate of 104

For which of these patients with a capillary refill time of three seconds to be most indicative of poor perfusion

A four-year-old male

Your partner is having a difficult time, determining normal and abnormal blood pressure for a child. Which of these statements will help him those?

A minimal acceptable systolic pressure can be estimated by doubling the child age and adding it to 70

Which of these statements indicates inappropriate understanding of palpating a blood pressure?

A palpated blood pressure is typically a little lower than a blood pressure obtained by auscultation

Which of these statements made by your EMT partner, indicates that he understands assessment of a patient's breathing?

A rate less than eight times, per minute may allow adequate breathing, but requires further evaluation and assessment

The fire department has requested your assistance at a residence where the families carbon monoxide detector has been going off. There are three patients. You first assess a 28-year-old female patient who states she has a sinus headache but otherwise feels fine. Her vital signs are pulse, 90; respirations, six teen breaths/minute; blood pressure, 118/6mmHg; and SPO2 100%. Given these assessment findings you should immediately:

Administer high-concentration oxygen

The EMT understands the primary reason to obtain a medical history using the SAMPLE mnemonic when he states:

After performing the primary assessment, the SAMPLE mnemonic helps guide the EMT and further assessment and care

Which of these descriptions would be obtained when asking about the "A" component in the SAMPLE history?

Allergy to penicillin

You are assessing a 49-year-old male patient who complains of lower back pain. Which finding would be pertinent medical information related to the back pain that the EMT will obtain using the SAMPLE mnemonic?

Arthritis in the spine and pelvis

You and a paramedic partner, or caring for a patient who overdosed on a drug that has caused her to become apneic. Your EMT student is providing BVM ventilation with supplemental oxygen via and endotracheal tube placed by the paramedic. The patient still has a good pulse and acceptable blood pressure. The pulse oximeter reads 95% and the ET CO2 monitor reads 28mmHg. Given these findings, the EMT should.

Ask the EMT student ventilating the patient to slow the ventilatory rate

You are unable to auscultate a blood pressure in a patient's right arm. What should you do next to obtain the most accurate baseline assessment of this patient vital signs?

Auscultate the blood pressure in the left arm

The EMT is correctly, using a noninvasive blood pressure monitor when she:

Auscultates a blood pressure before applying and activating the device

You are observing a new MT, just hired by your EMS agency. You know he has correctly positions to blood pressure cuff on the patient's arm one:

Because it's on the same level as the patient's heart

Where would the EMT palpate for a popliteal pulse?

Behind the knee

Assessment of a patient who is unresponsive reveals pupils that are both large at 6 mm and do not change in size in response to light. The EMT would best document this finding as:

Bilateral dilation of the pupils, unresponsive to light

A patient states that he is short of breath, is lightheaded, and has chest pain that worsens when he takes a deep breath. Assessment reveals an open airway, adequate breathing, and a rapid pulse of 120 bpm. The patient skin is hot to the touch, and he is has a blood pressure of 116/84 mmHg. The patient informed you that he was diagnosed with pneumonia three days ago and has not been taking the prescribed antibiotics. Which of these assessment findings with the EMT best recognized as a sign related to the patient's chief complaint?

Blood pressure 116/84mmHg

Your partner states that he wants to palpate the blood pressure. Which equipment would you hand him?

Blood pressure cuff

Which of these would indicate a normal pupillary exam has occurred?

Both pupils constrict when light is directed into one Eye

When obtaining a blood pressure, the EMT license for a pulse over which blood vessel?

Brachial artery

You determine a patient's heart rate to be 48 Beach/minute. That heart rate would be categorized as:

Bradycardic

Which of these statements made by an EMT student indicates that he correctly understands the use of capillary refill when assessing a patient

Capillary refill is a more reliable sign of perfusion quality in children younger than 6 years than in adolescent or adults

You are assessing a 61-year-old male patient who was confused. During the primary assessment, you cannot locate a radial pulse. Your immediate action should be two:

Check for a carotid pulse

Which of these statements made by an ENT indicates an accurate understanding of checking a patient skin temperature?

Checking, the skin temperature is not precise, but provides a good estimate of abnormally, high or low body temperatures.

If you have assisted the patient and taking one of his nitroglycerin tablets due to cardiac type chest pain. Five minutes later, you know the patient's blood pressure is 108/74 mmHg. To determine if the nitroglycerin has affected the blood pressure, the EMT should:

Compare this, finding to the baseline blood pressure

A 41-year-old male patient reacts to painful stimuli by moaning. You shine a light at his right people only, while you look at both peoples. What would be a normal finding?

Construction of the right and left peoples

When assessing a patient's pulse, you know that it is a regular. To get an accurate heart rate, you would:

Count the number of beats that occur in one minute

The EMTs correctly, calculating a patient's respiratory rate when he or she:

Count to the number of breaths for 30 seconds and multiplies by two

An EMT student asks you if it matters whether the blood pressure cuff seems too small for a patient, if a reading can't still be obtained. You should respond:

Cuss that are too small provide inaccurately high readings.

Assessment of a patient skin color reveals a bluish discoloration. As a knowledgeable EMT, you should identify:

Cyanosis is called by an adequate oxygenation of the tissues

You observe your partner correctly, obtaining a patient's blood pressure when he:

Deflates the cuff 2 mmHg per second while listening with a stethoscope

During the primary assessment of a geriatric, patient complaining of shortness of breath and fever, you quickly locate the radial pulse. What should you do next?

Determine the rate and quality of the pulse

When assessing a patient's pupils, the EMT should:

Determine the size of the people and then look for a change in pulpillary size when shining a light in the eye

When using the OPQRST mnemonic, the EMT is getting information as it applies to the "P" category when she asks :

Do you feel more short of breath when you are lying down?

Which of these questions with the ENT ask when using the OPQRST mnemonic?

Does the pain feel dull or sharp?

You believe a patient for whom you are caring is starting to experience respiratory failure. Which of these findings is supportive of the suspicion?

ETCO2 of 56 mmHg

You are assessing, I confused, dark skinned, patient who complains of a headache. When checking his skin color, you should:

Evaluate the palms of his hands or conjunctiva

You are transporting a depressed patient who states that she is thinking of killing herself by taking a whole bunch of pills. After providing this information, the patient has refused to speak. It has remain silent. Your physical assessment of the patient reveal she is stable. How often should vital signs be reassessed?

Every 15 minutes

You and a paramedic partner, or caring for a patient who overdose on a drug that has caused her to become apneic. Your EMT student is providing BVM ventilation with supplemental oxygen via an endotracheal tube placed by the paramedic. How often should vital signs be reassessed on this patient?

Every five minutes

You notice that your partner routinely takes only one set of vital signs when treating in transporting patients. When asked, he states that he gets just baseline, vital signs because they are most important, and they provide information relating to the patient clinical status at the time of the EMS call. How would you respond?

Examining several sets of vital signs can also indicate the effectiveness of your treatment

You are attempting to get a history from a 56-year-old female patient who is short of breath. When you ask questions, the daughter continuingly answers for the patient. Two best handle the situation, you should:

Explain to the daughter it is important for the patient to answer whenever possible

The purpose of the OPQRST mnemonic, as to guide the EMT in:

Exploring the patient's chief complaint

What is the name of the pulse that is palpated in the groin area?

Femoral

The EMTs correctly palpating a central pulse when he palpates the colon

Femoral post

When using a pulse oximeter on a adult patient, the EMT knows that the sensor is most often attached to the patient

Finger

To test a pediatric patients, capillary refill, the EMT will:

Firmly compress and then release pressure on the nail bed.

A pulse oximetry reading obtained on room air is considered normal when it is

Greater than 97%

An obese, female patient has called you with a complaint of abdominal pain. The regular adult cough would not fit around her arm, so you retrieve a large adult car from your supplies. Embarrassed, the woman says, "my arm is so fat. Do you really need to roll up my sleeves to get my blood pressure?" Your best response would be:

I am not concerned with the size of your arm. I am interested in your blood pressure.

An 86-year-old female patient has called 911 for rectal bleeding. There's a large amount of dark red blood and clots in the toilet and on the patient clothing. The emergency medical responderal reports blood pressure of 84/68 with a heart rate of 124 bpm given this information, the EMT should expect findings of.

I narrowed pulse pressure and possible shock

Your EMT student has a good understanding of end-tidal carbon dioxide monitoring when she states:

I need a service to the breathing, circulation, or metabolic state of the patient can alter the reading.

A patient with chest pain informs you that the pain is greater when he takes a deep breath. The EMT is using the active, listening techniques of "facilitation" and "clarification" when he responds by saying.

I see. Can you describe what the pain feels like?

Using the SAMPLE mnemonic, which of these statements made by the patient would be categorized under the letter M?

I take Zocor, but I'm not sure why

You are transporting a depressed patient who said she's thinking of killing yourself I taking a whole bunch of pills. After providing you this information, The Patient has refused to speak, and has remain silent. Your physical assessment of the patient reveal she is stable. Which of these statements would be most appropriate for you to make it this time?

I understand if you do not want to talk. I will be sitting here if you need anything.

You have placed the blood pressure cuff on the arm of a patient who is short of breath. What is your next step?

Inflate to a reading of 70 mmHg, check for radial pulse, and continue inflation, until the pulse is no longer felt

A few more patient called 911 when she noticed blood in her stool. And became scared and anxious. Her pulse rate is 124 and her blood pressure is 88/60mmHg. After you get her vital signs, she nervously asks you how they are. Given her anxiety, you should:

Inform her of the vital signs

You have been dispatched to a residence for a 14-year-old female patient complaining of abdominal pain. As you enter the living room, you see the conscious patient lying on the couch with her father in an emergency medical responder and her at her side. What action should the EMT perform first?

Introduce yourself and your partner

An EMT has an accurate understanding of diastolic blood pressure when she tells you that diastolic pressure:

Is the pressure in the arteries in the heart is not contracting

When you are applying the pulse oximeter to a patient finger, he asks you what the devices for. Your response would be:

It measures the amount of oxygen being carried by your blood cells

A patient with liver cancer exhibit a yellow discoloration to his entire body. The EMT would correctly document this condition as:

Jaundice

You've been dispatched to a residence for a female patient with unknown injuries. At the patient side, you quickly become aware that the 43 year old female was assaulted by her husband. The husband comes into the room and state, don't you touch her, or I will take care of you, too! What should be the EMTs immediate action?

Leave the house immediately, taking the patient with you, if possible

you have a plied the pulse oximeter to a 73-year-old male patient who complains of weakness and heart palpitations. Your partner reports that the patient's breath sounds are clear and equal, with a respiratory rate of 16 breaths/minute and skin that is warm, but pale in color. He then states the following vital signs: pulse, 92; blood pressure, 168/70 mmHg; and SPO2, 92% on room air. Given this information, which of these instructions would be most appropriate?

Less initiate oxygen at 2 L per minute via a nasal cannula

A patient who appears to be intoxicated, has fallen and is complaining of pain to his right arm. He is loud and using profane language. What should be your initial approach to the patient?

Let me apply an ice pack. It will help it feel better.

In patients with which of these conditions with the EMT most likely get an inaccurate pulse oximeter reading, despite proper application of the sensor?

Low blood pressure

You have been called to a bar for a patient who was involved in an altercation and is complaining of abdominal pain. Law-enforcement is present. The patient has been handcuffed and is sitting on the sidewalk. He has an odor of alcohol in his breath, his speech is slurred, and he has angrily yelling at the police officers. Which action would be most appropriate for the EMT to take when talking to the patient?

Maintain eye contact to help establish a rapport

You are assessing a female patient with a complaining of shortness of breath. When assessing her skin, which findings should be recognized as abnormal?

Moist

which of these statements made by a patient with the AMT regard as a symptom?

My penis, sharp, the worst I've ever felt

As you enter the scene of a medical emergency, the emergency medical responder informs you that the patient is not breathing and has people that are fixed and dilated. Based on this description, what do you expect to see when you reach the patient side?

Neither people will react when light is directed into the eyes

Which of these would be an indication to palpate the blood pressure?

Noisy environment

When evaluating a patient skin color, the EMT should

Observe the nail beds, and/or mucous membranes inside the eyelids

If you were a patient with a history of asthma, called 911 with a complaint of shortness of breath. On Skin, you assist her with the administration of her metered dose inhaler containing albuterol. What can the EMT do? Best to determine if this patient condition is improving?

Obtain a pulse Oximetry reading, and breath sounds every five minutes

An EMT has accurately check the skin color of a dark skinned patient. How would this finding best be documented on a patient care report?

Pale color noted to the conjunctiva

A 43-year-old female has accidentally taken too much of her antidepressant medication and is now confused. Emergency medical responders are on scene and providing the patient with high concentration oxygen. As you arrive at the patient's side, your first action should be tO:

Perform a primary assessment

The EMT should recognize normal skin color and a healthy patient as

Pink

When you are obtaining a blood pressure of a patient in a standing position, the patient states that he suddenly feels weak, and is going to pass out. Your immediate action should be two:

Place the patient back into the bed

You were trying to get a pulse oximeter reading on an 18 month old child with difficulty breathing. Every time you place the sensor on the child's finger, he becomes upset and removed it. What is your best course of action?

Places sensor on the child's toe

Which of these methods most accurately assess a patient's skin temperature?

Placing the back of the hand on the patient's abdomen

An EMT has an accurate understanding of systolic blood pressure when he tells you that systolic blood pressure is:

Produced when a heart contracts

You have arrived by the side of a cyanotic patient who is responsive only to painful stimuli and exhibiting stridorous respirations. What is the most appropriate action by the EMT?

Provide positive pressure ventilation with supplemental oxygen

After you apply the pulse oximeter to a patient who complains of chest discomfort, she asks you what you are assessing. You would respond by telling her that the pulse oximeter:

Provides information about the amount of oxygen circulating in the blood

Friends called 911, for 37-year-old female, who intentionally overdose on a narcotic drug in a college party. Which I related findings would reinforce that the patient did, indeed take a narcotic?

Pupils that are constructed

Which poolside is commonly palpitated during the process of obtaining a blood pressure by the palpitation technique

Radial

You have been called to assess a conscious and alert, five-year-old child who is chief complaint is nausea and vomiting over the last two hours. When assessing his pulse you should first check which pulse?

Radial

A patient presents with extremely pale skin. His family states that this is not his normal skin color. His vital signs are pulse, 118; respirations, 18 breaths per minute; blood pressure, 102/86 mmHg; and SPO2, 96%. Which complaint would make the most sense given this clinical presentation?

Rectal bleeding

Which steps should be taken by the EMT to obtain an accurate pulse oximetry measurement?

Remove nail polish from the patient's fingernail if present

When assessing a patient who does not speak the same language as you were your partner, the best approach in the immediate care of the patient is to:

Request that a family member act as an interpreter

Emergency medical responders inform you that a 27-year-old male patient with altered mental status has an open airway and his breathing nine times every 30 seconds. His pulse rate is 40 beats/minute, and he has bruises to his chest. Based on his vital signs and presentation information, the EMT should recognize the:

Respiratory rate as normal

Which of these findings related to breathing would be most concerning to the EMT in an adult patient

Respiratory rate of 20, use of accessory muscles

When should the EMT use the pulse oximeter?

Routinely on all patients with a medical or trauma complaint

Which of these pieces of information would be obtained by the EMT when getting a history of the in SAMPLE mnemonic?

Sensation of dizziness prior to falling

You are assessing a patient who is in bright sunlight, after collapsing in the hot sun at a picnic. If you cannot immediately move, the patient out of the sun, assessment of the pupils will be made more accurate by:

Shading the patient's eyes

You are called to a long term care facility to assess and transport a patient with a high fever. You do not have a thermometer under unit. Which alternative sign should you use to confirm the patient increased body temperature?

Skin on the abdomen that is hot and flushed

You were caring for a five-year-old male patient with a complaint of difficulty breathing. Your assessment indicate that the patient is Tachypneic with labored breathing. Or gaining more information about the patient's respiratory function, which, finding would you recognize most important?

Skin retractions between the ribs when inhaling

A mother is called 911, because her two year old is fussy and not eating. When assessing the toddler, what would be the best indication of her perfusion status?

Skin, color and temperature

Which of these patient descriptions contain only vital signs?

Skin, warm, and dry; heart rate, 74 beats/minute; pupils, equal and reactive

The EMT is correct when he makes which of These statements about assessment of the pupils?

Some people naturally have unequal pupils, but both should react to light.

To assess a patient's blood pressure, the EMT will need a:

Sphygmomanometer

Medical direction has asked you to obtain orthostatic vital signs for a 54-year-old female patient who complains of dizziness and weakness. Her baseline vital signs obtained while she was sitting in a chair, or pulse, 84; respirations, 26 breaths/minute; blood pressure, 118/62mmHg; & SPO2, 95%. Which one set of vitals upon reassessment would indicate that this patient has a positive orthostatic test?

Standing blood pressure of 92/54mmHg, and a heart rate of 106 beats/minute

Which of these characteristics would be considered a pulse "quality" factor?

Strength

A young female patient has been stung by a bee and complains that her throat is closing up. She states that she is allergic to bee stings; the last time this happened, she had to have a to put in my windpipe. She is struggling to breathe, and can only speak a few words at a time. Knowing that allergic reactions can cause swelling to the pharynx and the larynx, what airway sound with indicate that the patient indeed has swelling in this area?

Stridor

You determine a patient's radial pulses readily palpable, but has uneven intervals between beach. This finding would best be documented on the prehospital care report, as:

Strong and a regular

Correctly, assessing orthostatic, vital signs involves:

Taking the blood pressure in the supine, seated, and standing positions

When obtaining vital signs for 867 year, old male, patient with dizziness and nausea, your partner states that the pool seems to disappear periodically when the patient takes a deep breath. As a knowledgeable EMT call me your best response would be:

That is an important finding. We will have to let the doctor know about it.

A patient who is shoveling snow, develop chest pain, immediately sat down in the nearby, bus, shelter, and called 911 prior to moving him into the ambulance, your partner performs a primary assessment and reports that the patient capillary refill is five seconds. Which of these would be an appropriate statement for you to meet?

The cold temperature may cause the capillary refill to be five seconds; we should assess further

Your partner reports that a patient's blood pressure is 156/78mmHg. From this reading, you realize:

The diastolic blood pressure is 78 mmHg

The EMT is reviewing a patient care report and find the following documentation "ET CO2 is 43mmHg. "What does this mean?

The exhale carbon dioxide level is normal

The EMT is correct when he identifies baseline vital signs as

The first set of vital signs obtained

Hey 69 year old man, complains of weakness of the left arm and leg. He also states that he is nauseated and has a headache. The patient past medical history includes strokes and diabetes. In relation to this information, which of these statements is true?

The headache is a symptom related to the chief complaint

Which of these statements concerning assessment of the post this correct?

The heart rate can be determined by doubling the number of beats counted in 30 seconds.

When assessing a patient's pulse, you can locate the right radial pulse, but not the left. What is the most likely explanation for this finding

The left radial artery may be occluded

And alert and oriented 87-year-old female patient has fallen and suffered a 3 cm laceration to the back of her head. According to the patient, her walker became caught in the carpet, causing her to trip. When obtaining a medical history, who should the EMT address first

The patient

You cannot obtain a reading on a pulse oximeter after applying the sensor to the patient's finger. What would be the most common reason for this difficulty?

The patient's hands are cold

Hey blood pressure has reported at 116/68 mmHg Given this finding, which of these statements is true?

The systolic blood pressure is 116mmHg

When obtaining a blood pressure for a patient, the radial pulse disappears when the gauge reads 130mmHg. When deflating the cuff, the EMT here's a pulse at 118mmHg. The pulse disappears at 76mmHg. Given this, which of these statements is true?

The systolic blood pressure is 118mmHg

A Family has called 911 for a 41-year-old male family member, whom they cannot wake up. They state he has been threatening to kill himself and believe he may have intentionally overdosed on his pain medication's. As you enter the patient bedroom, you observe him supine on the floor with his eyes closed. As he breeds, you hear her snoring respirations. As a knowledgeable, EMT, you recognize that this condition is likely caused by:

The tongue partially blocking the airway

Which of these statements is true regarding vital signs obtained from a patient with nausea and vomiting?

The vital signs will help the ENT determine the relative stability or instability of the patient

When obtaining a medical history, using the SAMPLE mnemonic, which of these statements relates to the "P" component?

There's a history of pancreatitis

A patient presents with skin that is cool to the touch. The EMT shows he understands his condition when he states:

This may indicate a problem with the patient's blood circulation

An EMT is correctly, assessing a patient's radial pulse when he:

Uses his fingertips to feel for a pulse on the anterior and lateral aspect of the patient's wrist

Which of these questions would be asked when obtaining a medical history, using the SAMPLE mnemonic, for a female patient who is crying and complaining of dizziness?

What were you doing when the dizziness started?

The EMT is appropriately using the SAMPLE mnemonic when he asks which question?

When did you last eat?

Which of these is an example of an open ended question?

Why did you call 911?

A patient has advanced liver disease from years of exposure to toxic chemicals in his place of employment. Which skin color with the ENT expect given the status?

Yellow orange